先天性心脏病介入治疗57例

Interventional Therapy for 57 Patients with Congenital Heart Diseases

目的分析常见先天性心脏病(先心病)介入治疗的疗效。方法回顾性分析2009年3月至2012年1月德阳市人民医院经导管介入治疗57例先心病患者的临床资料,男31例,女26例;年龄1.5～75.0(29.4±3.5)岁。单纯动脉导管未闭(PDA)21例,室间隔缺损(VSD)12例,房间隔缺损(ASD)20例;VSD合并ASD 2例,VSD合并PDA 1例,ASD合并PDA 1例。均采用国产封堵器及输送系统。ASD合并PDA患者先封堵动脉导管,再封堵ASD;VSD合并PDA患者先堵动脉导管,再封堵VSD;VSD合并ASD患者先封堵VSD,再封堵ASD。结果介入治疗手术时间30～90 min。全组手术成功56例,成功率98.3%(56/57),1例老年女性ASD患者合并慢性肺源性心脏病,因肺动脉压高放弃封堵而终止手术。住院时间3～7 d。全组门诊以心脏彩色超声心动图、胸部X线片、心电图随访1个月～2年,无并发症发生。结论只要严格掌握手术适应证,规范操作,经导管介入治疗先心病安全、微创、疗效确切。

Objective To analyze clinical outcomes of interventional therapy for common congenital heart diseases （CHD）. Methods We retrospectively analyzed the clinical records of 57 patients with CHD who underwent catheter interventional therapy in People＇s Hospital of Deyang City between March 2009 and January 2012. There were 31 male patients and 26 female patients with their mean age of 29. 4-t-3.5 years （ranging from 1.5 to 75.0 years）. There were 21 patients with patent ductus arteriosus （PDA）, 12 patients with ventricular septal defect （VSD）, and 20 patients with atrial septal defect （ASD） ; and 2 patients with VSD plus ASD, 1 patient with VSD plus PDA, and 1 patient with ASD plus PDA. Occluder and supplying system made in China were used in the interventional therapy. For the patients with ASD plus PDA, PDA was blocked before ASD; for the patients with VSD plus PDA, PDA was blocked before VSD; and for the patients with VSD plus ASD, VSD was blocked before ASD. Results The duration of interventional therapy ranged from 30 to 90 minutes. The success rate of operation was 98.3% （56/57）. Operation was given up in an old female patient with ASD and chronic obstructive pulmonary disease because of pulmonary hypertension. The hospital stay was 3 -7 days. All the patients were followed up at the outpatient department for 1 month to 2 years by color Doppler echocardiogram, chest X-ray and electrocardiograph, and no complication occurred during follow-up. Conclusion With complete understanding of surgical indications and strict compliance with procedures, catheter interventional therapy is safe, minimal invasive, and effective in CHD treatment.